FREQUENTLY ASKED QUESTIONS
27 FAQs about Unauthorized Practice & Title Use
1. Who is permitted to practice podiatric medicine in British Columbia ?
The BC Health Professions Act permits only those individuals who are registered by the College of Podiatric Surgeons of British Columbia (CPS-BC) to practice podiatric medicine in B.C.
2. Who determines who may be registered to practice podiatric medicine in BC ?
The College of Podiatric Surgeons of BC is the body that is responsible for setting the admissions standards for the profession and determining who may be registered to practice in the province.
3. Is podiatric medicine the same as podiatry ?
Yes; at least within B.C., Alberta and the U.S. – in these jurisdictions the terms are interchangeable and connote a Doctor of Podiatric Medicine (DPM) level of training. Note however, that in some other provinces and internationally outside of the U.S., ‘podiatry’ is sometimes used synonymously with other levels of foot care training like chiropody.
4. Are there any restrictions on who can use the title ‘podiatrist’ and similar titles ?
Yes; the Podiatrists Regulation to the Health Professions Act expressly reserves or restricts the use of the following titles to registrants of the CPS-BC:
– podiatric surgeon
Section 12.1 of the Health Professions Act goes further: a non-registrant must not use any name, title, description or abbreviation of a name or title, or the equivalent in a foreign language, in any manner that conveys that they are a registrant of the College.
Remember: a true ‘CPod’ or ‘RPod’ is a podiatrist who has the certificate of registration granted by the CPS-BC.
5. Are there any exceptions to this ?
Yes; the prohibition on the titles ‘surgeon’ and ‘doctor’ does not apply to persons who are also authorized by a regulation under the Health Professions Act to use the terms, or to an academic or educational designation that a person is entitled to use.
See also section 12.2 of the Health Professions Act which permits individuals to use titles for the purpose of conveying that they are permitted to practice a certain occupation in another jurisdiction (but not BC).
6. How can I know that a person who has ‘pod’in their job title is actually a podiatrist registered with the College ?
The only way to know for sure is to contact the College and/or check our searchable directory or geographical directory, both of which are accessible on this website.
7. May unregulated persons use terms such as ‘podiatric care’, ‘medical foot care’, ‘podiatric treatment’, etc. ?
No. This is misleading to the public and the College will investigate where there is evidence of the use of such terms by unregulated individuals.
8. What is the definition and scope of the practice of podiatric medicine ?
See the Podiatrists Regulation under the Health Professions Act.
9. What is a ‘restricted act’ under the BC Health Professions Act ?
A restricted act is a task that may only legally be performed by a member of a regulated profession under the Health Professions Act that is granted the authority to perform the act by regulations under the Act.
10. Does the law allow a person who is not a registrant of the College to practice podiatric medicine/podiatry in BC ?
11. Are there any exceptions to this ?
The scope of practice and restricted acts (see below) of some other regulated professions, partially or fully overlap that of podiatry. The main example is MDs (‘Medical Doctors’ as opposed to DPMs or Doctors of Podiatric Medicine).
12. Does the law allow unregulated persons to deliver any podiatric services ? Under what circumstances ?
Some tasks may be delegated, by a registered podiatrist, to a person who is not a registrant of the College, if the delegation is in accordance with the law and the policies of the College. The delegation must include the level of supervision by the registrant that is appropriate for the task to be performed.
13. To whom may podiatrists delegate tasks ?
A podiatrist may delegate a restricted act to an individual who is a registrant of profession that is granted the authority under the Health Professions Act, to carry out that task upon the order of a podiatrist. As an example, registered nurses may apply laser for the purpose of destroying tissue, but only upon the order of a registered podiatrist (or MD).
A podiatrist may delegate other (non-restricted) tasks to personnel whom they on a reasonable basis believe to be competent to carry out the task.
14. Who has the responsibility for the competent performance of delegated tasks ?
The delegating or treating podiatrist has the responsibility and is answerable for the performance and outcome of any delegated tasks.
15. Who may charge a fee for delegated services ?
The treating or delegating podiatrist should render the bill for delegated tasks, and the podiatrist rather than the patient should remit appropriate payment to the delegee.
16. Is delegation of a task the same as a referral ?
No. A referral is to an individual who has the legal authority to independently provide the service for which the patient is being referred.
17. To whom may podiatrists refer patients ?
A podiatrist may refer a patient to another podiatrist, or another regulated professional who has the legal authority to carry out the task for which the patient is being referred.
A podiatrist may not refer a patient to an unregulated individual for the performance of any service that falls only to regulated professionals under the Health Professions Act.
18. How does the CPS-BC stop illegal practice ?
In most cases the College will seek a consent resolution with the individuals and entities who have been delivering illegal services, using restricted titles or making unauthorized representations. That agreement will consist largely of undertakings to cease and desist the offending conduct.
19. Can the CPS-BC obtain an injunction against an illegal practitioner ?
Yes; the Health Professions Act authorizes the College to apply to the Supreme Court for an injunction.
20. Can the CPS-BC seize an illegal practitioner’s equipment ?
Yes; the Health Professions Act authorizes the College to apply to the Supreme Court for an order to seize equipment that has been used in unlawful practice, in order to protect the public.
21. Is unlawful practice an offence ?
Yes; the Health Professions Act makes it an offence to engage in unlawful practice or use of titles.
22. If so, what is the possible penalty ?
A person who is convicted of unlawful practice or use of titles is liable to a fine of not more than $2,000 or to imprisonment for not more than 6 months, or to both.
23. May an unregulated person prescribe orthotics for patients ?
No. The diagnosis of a biomechanical condition or any other condition that might be treated by orthotics, and the issuing of a prescription for treatment of any condition, including orthotics, falls to a regulated professional whose scope of practice encompasses those tasks.
24. May a podiatrist delegate any tasks relating to orthotics to an unregulated individual ?
Yes. A podiatrist may delegate the manufacture of orthotics, but not the act of issuing a prescription for orthotics.
25. May a non-podiatrist apply laser therapy for the purpose of treating feet ?
No. The uses of laser for treating conditions such as fungus, warts, moles and neuromas involve the application of laser for the purpose of destroying tissue, which is a restricted activity under regulations to the Health Professions Act including the Podiatrists Regulation.
26. What are common areas of unauthorized practice of podiatry ?
Frequently seen examples include:
– Diagnosis of any foot conditions, including skin conditions such as warts, fungus and moles
– Diagnosis of subsurface conditions such as plantar fasciitis and neuromas
– Laser treatment of the conditions listed above
– Prescription of other treatments for any foot condition
– Diagnosis of biomechanical conditions
– Prescription of orthotics
– Assessment of treatment efficacy
27. What are some of risks of unauthorized practice ?
Unlawful practice poses a significant and potentially serious risk to the quality of care and safety for the individual patient and the public at large. Members of the public endanger their health by entrusting their care to unauthorized and unregulated providers.
There is no assurance that the unauthorized person has the necessary education and evaluation, and is therefore qualified and competent to practice podiatric medicine; to understand and carry out diagnostic investigations, reach a diagnosis, recommend appropriate treatment and prescribe appropriate medications, and assess the treatment outcome.
There is a significant risk of incorrect diagnosis and inappropriate treatment. Most concerning is the potential for a missed diagnosis – for example a failure to recognize a cancerous lesion – and resulting failure to provide critically needed treatment; a potentially catastrophic situation for the patient.
Another example is the risks posed by laser treatments on the feet, for conditions such as fungus, warts, moles and neuromas. Unregulated persons are not legally permitted to perform these tasks; yet many spas offer these services. They present a particular risk to diabetic patients who cannot feel the heat and are at enhanced risk of severe burns.
There is an enhanced risk of exposure to pathogens, and therefore serious infection. The patient has no assurance that the materials and equipment used in their care and treatment have been cleaned and processed to the standards of cleanliness and sterility that are required by the College.
With unlicensed purveyors, there is no accountability to a governing regulatory body who has statutory powers to set and enforce practice and equipment standards, and to investigate complaints and intervene in situations of poor or unsatisfactory treatment or outcomes to prevent a recurrence.